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Primary care practices in Louisiana, Nebraska, North Dakota and New York’s Erie and Niagara Counties can now apply to participate in the second round of CMS’s Comprehensive Primary Care Plus (CPC+) model.

For the second time under the Trump administration, CMS has delayed the implementation date of bundled payments for cardiac care and an expansion of a joint replacement model, which are now due to begin Jan. 1, 2018, opening the door to additional changes, like making the models voluntary rather than mandatory.  

Two large hospitals in the Los Angeles area would be under the same parent organization under a proposed affiliation plan announced by Cedars-Sinai and Torrance Memorial Medical Center.

Geisinger Health System and insurer Highmark have signed a letter of intent for a new joint venture to develop a new clinical network and reimbursement in four Pennsylvania counties.

New renderings have been released of the new pediatric and obstetric hospital campus at Lucile Packard Children’s Hospital Stanford, which is now slated to open in December, five years after the groundbreaking for the facility. 


Recent Headlines

CareMore, Emory to tackle reducing costs and improving outcomes in Georgia seniors

WellPoint Inc.’s Cerritos, Calif.-based subsidiary CareMore and Atlanta-based Emory Healthcare say they will team up to expand CareMore’s model of care management for Medicare Advantage patients in Georgia.

Hospital groups launch website to improve perception of consolidation

The American Hospital Association and the Federation of American Hospitals have joined forces on, a new website that aims to explain how realignment and consolidation of hospital systems can help communities and patients.

Majority of physician practices not joining ACOs

A national telephone survey finds that 60.6 percent of physician organizations report no current involvement and no plans to become involved in an accountable care organization (ACO) in the near future.

NCQA Updates Medical Home Standards Amidst Criticism for Lack of Focus on Outcomes

The National Committee for Quality Assurance (NCQA) is updating its standards for Patient-Centered Medical Home Recognition, as concern grows that the standards focus too heavily on structural elements of medical homes and not enough on outcomes.

Reducing Unnecessary Readmissions Requires Carrots, Not Just Sticks

Lowering unnecessary hospital readmission rates is an often cited solution to the problem of high U.S. health care costs. However, to effectively do so, the health care system needs to reward all stakeholders for collaborating, not just punish hospitals for unnecessary readmissions, a new report finds.

Wisconsin Hospitals Raise the Quality Bar—Across the Board

Reducing readmissions remains one of the most difficult challenges for hospitals everywhere. Members of the Wisconsin Hospital Association (WHA), however, have been working together to reduce the incidence of hospital readmissions within 30 days of discharge—and their performance runs far ahead of the national average.

Highmark May Gain Additional Leverage With Blues Merger

A merger agreement between Blue Cross of Northeastern Pennsylvania (BCNEPA) and Highmark Inc. could bring together two of Pennsylvania’s leading not-for-profit health insurance companies and become a factor in the long-running dispute between Highmark and UPMC, the region's largest health system.

BCBS of Michigan Adds Five Hospital Systems to New Reimbursement Model

Five hospital systems that together represent 24 Michigan hospitals have joined or expanded their participation in Detroit-based Blue Cross Blue Shield of Michigan’s value-based hospital reimbursement model. Similar to the accountable care organization (ACO) idea of lowering costs while improving quality through better care coordination and a focus on outcomes, the new model requires the hospitals to “identify their provider partners in the community and work with them to develop and implement an infrastructure plan that includes an all-patient registry system that allows caregivers at the hospital and in the physician offices to measure an individual’s health performance against similar populations.”

Early Medicare ACO Results Mixed

According to the Centers for Medicare and Medicaid Services (CMS), one year into the Medicare Accountable Care Organization (ACO) initiative, a little less than half (54) of the 114 participating organizations have achieved savings and of those, just 29 saved enough money to receive “shared savings” bonuses. In addition, an in-depth savings analysis for the 29 participating Pioneer ACOs showed that nine achieved significant savings while also scoring high quality metrics.

21 Hospitals Enter Phase 2 in Bundled Prospective Payment Bet

Among the 232 health care providers that have entered into agreements in the now 1-year-old Centers for Medicare & Medicaid Services (CMS) Bundled Payments for Care Improvement initiative, 21 acute care hospitals have begun the second phase of the payment model that is the cleanest break with traditional fee-for-service.